ICE Magazine November 2021

NOVEMBER 2021 | VOLUME 5 | ISSUE 11

THEICECOMMUNITY.COM

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

PRODUCT FOCUS In Focus

BRANDON A. SMITH PAGE 10

Find a Partner

Managing Disparate Needs to Improve HTM Outcomes PAGE 32

nuclear medicine PAGE 30

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EMOTIONAL INTELLIGENCE

RAD HR

Psychological safety is the belief that you won’t face negative consequences for speaking up, making mistakes, or taking risks.

Displaying bad manners is never good for one’s reputation or business.

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COVER STORY

In any health care organization, collaboration is an engine that drives success. Often the relationships that produce the greatest results are those that fulfill institutional aims while also supporting the success of individual departments.

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OFF THE CLOCK

X-ray technologist Patricia Hammer stops to plant and smell the flowers as she brings ecological conscience into the world.

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ICEMAGAZINE | NOVEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

NOVEMBER 2021

18 PRODUCT FOCUS A look at some of the leading nuclear medicine devices.

IMAGING NEWS

The latest medical imaging news from around North America.

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13 RISING STAR

Summer Powers grew up in the foothills of the Appalachian Mountains and is an imaging star on the rise.

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MD Publishing 1015 Tyrone Rd. Ste. 120 Tyrone, GA 30290 Phone: 800-906-3373 Fax: 770-632-9090 Publisher

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editorial

John Wallace Erin Register

Art Department Jonathan Riley Karlee Gower Taylor Powers

Account Executives Jayme McKelvey Megan Cabot

Events

CONTENTS SPOTLIGHT

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In Focus Brandon A. Smith, MBA., MSRS, RT (R)(VI), CIIP

13

Rising Star Summer Powers, B.S.R.S, ARRT R.T.(R).

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Off the Clock Patricia Hammer, X-ray Technologist.

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Rad Idea Birds, Nature Boost Health.

NEWS

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Imaging News A Look at What’s Changing in the Imaging Industry

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RSNA 2021 Showcase Highlights planned for the 107th Annual Meeting

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ICE Webinars Presenters Deliver Imaging Insights

Kristin Leavoy

Circulation

Jennifer Godwin

Webinars

Jennifer Godwin

Digital Department Cindy Galindo Kennedy Krieg

Accounting Diane Costea

Editorial Board

Laurie Schachtner Nicole T. Walton-Trujillo Mario Pistilli Jef Williams Christopher Nowak ICE Magazine (Vol. 5, Issue #10) October 2021 is published by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

POSTMASTER: Send address changes to ICE Magazine at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

For subscription information visit www.theicecommunity.com.

The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2021

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ICEMAGAZINE | NOVEMBER 2021

PRODUCTS

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Market Report Nuclear Medicine Market Faces Challenges

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Product Focus Nuclear Medicine

INSIGHTS

36 Coding/Billing Extenders and Supervision 38 Rad HR Psychological Safety in the Interview Process 40 Director’s Cut Remember the Why 42 The Journey Toward Becoming an ACR Breast Center of Excellence

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PACS/IT Fogged Memory

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Emotional Intelligence How Bad Manners Can Be Good For You

48

Roman Review 50 Career Center

53 54 55

AMSP Member Profile

Index ICE Break ADVANCING THE IMAGING PROFESSIONAL

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EDUCATION EXHIBIT HALL NETWORKING FUN!

“A great opportunity to gain insight from industry peers and leaders from around the country.”

– R. Walston, Regional Director

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SPOTLIGHT

IN FOCUS

BRANDON A. SMITH

BY JOHN WALLACE

A

s a radiology applications specialist, he supports new application implementations, upgrades and existing customer support by developing educational plans, implementing training strategies and overall customer empowerment. Smith says that he collaborates with physicians, technologists, clinicians, IT administrators, support staff and internal customers to promote product support and end-user success. He explains that he is responsible for making the customer the application expert.

It is not unusual for a son to follow in his father’s footsteps, but children often want to strike out on their own and experience a different career field. For Smith, it was a hybrid experience that led him to become a radiology applications specialist and an imaging leader.

“I am a second-generation medical imaging professional. My father entered the field in the late ’80s. The profession was always intriguing, but I wanted to go my own path,” Smith explains. “I eventually entered the radiologic technology program at Lamar Institute of Technology (LIT) and later Midwestern State University. The relationships I built as a student, technologist and advocate – in addition to my upbringing – propelled me into my journey toward professionalism, advocacy and community.

Medical imaging became my career and an 10

ICEMAGAZINE | NOVEMBER 2021

integral part of my purpose.”

The decision to enter the imaging field is one that continues to pay dividends.

“I am empowered by the opportunity to represent and celebrate ‘us.’ By ‘us,’ I mean medical imaging professionals and therapists as exceptional contributors to health care.

Not in contrast to others associated with the field, but in collaboration,” Smith says. “Our modalities make us unique, but our profession makes us unified. We are one profession.

I believe championing such an idea promotes a synergy elevating patient care and the communities we serve. I leap at the opportunity to articulate who we are, what we do and celebrate the expertise of my colleagues.”

“As a person and professional, I love to impress and demonstrate our value in complement to those we work alongside. I work across teams to show how our talents are transferrable, not limited, to any one sector: health care, business, academia or industry,” Smith says.

Mentors have helped shape the way Smith approaches his work, as well as his leadership style.

“Three mentors who come to mind are Marlon Hickman, Debbie Callais and J. Alexander. Each mentor has added and continues to add, to my versatility as a person and professional. Hickman elevated my thinking to better understand the sacrifices of true service. Servant leadership can be thankless, taxing and lacking in support, but the conviction of purpose is self-sustaining. The work is intended to benefit community success more than self-gratification,” Smith says. “Callais coached me in comprehensive leadership.

ADVANCING THE IMAGING PROFESSIONAL

Own the problem and share the reward. She was a phenomenal director who mentored me to understand high-scale accountability, redefining confrontational as a positive attribute and being decisive in consideration of all impacted. Alexander challenges me regularly to appreciate my brand and the power of visibility to effectively articulate the message. She does not take excuses and prioritizes the celebration of others.”

“All of which have contributed to my enthusiasm and unwavering dedication to empower others,” he adds. “My sense of community is a result of being a product of my community’s investment in me. Anything I contribute to the communities I serve are what I owe as a member of those communities. This is a value I lead off with to those I mentor. Becoming a mentor has been one of the most intimidating yet meaningful obligations I have faced. My goal is simply to give them the science of what I have learned and allow them to champion the art of how they create new legacies, achievements and inspirations.”

He described his leadership style as, “Manage processes and promote people.”

“My focus is to facilitate an environment for team success through effective processes and support,” he explains. “The promotion of people describes encouraging and helping develop talent, empowering people to be champions of tasks, projects, and initiatives, and employing accountability as a coaching strategy, a positive approach to corrective action.

My goal is to align with those I support toward their vision of success as individuals and a team, reciprocally.”

Smith adds that “collaboration is more than a buzzword.”

“Its essence is based on a shareholder’s culture where opportunities are earned, qualifications are met and our talents can complement more than compete,” he says.

“The celebration of the success of others is not a discount of anyone else. Integrated solutions and interdisciplinary teams collaborating achieve more. As a medical imaging professional, I am an enthusiast of all the modalities of my profession and the other professions we work alongside.

When I am not the expert in a scenario, I champion the

opportunity to promote those who are whenever it applies in hopes of the same consideration.”

Smith also mentioned a fourth mentor.

“Dr. Michael Ward has been an incredible mentor and voice of reason. He has been a major part of my development as a leader in medical imaging. His sound advice and eloquent approach is nothing less than remarkable,” he says.

Family plays a meaninful role in Smith’s life.

“Family is a choice. It is more than being related; but the decision we make to be there for each other. I am blessed with an incredible family and friends who are family. My amazing wife, Megan and three sons, Laiden, Baylor, and Shaun are who I aim to make proud more than anything else. They inspire me every day to love on purpose, with purpose,” he explains.

Looking toward the future, a third-generation imaging professional from Smith’s family would not be a surprise.

“My oldest son, 12 years old at the time, wanted to attend a presentation I delivered to a group of professionals and students. He was interested in learning more about what I do and why I traveled so often. I figured he would be bored out of his mind. He sat front and center as I spoke to the crowd,” Smith says when asked about his greatest achievement. “Afterwards, he waited patiently as I met and conversed with several attendees. A colleague explained to my son my role in the state of Texas as an advocacy leader and her thoughts about my leadership. My son met many people who wanted to talk to him about his dad that day.”

“On the ride back home, he told me he was proud of me. We had a conversation about the importance of being accountable for others and always contributing your best to community,” he adds. “Among many notable things I have been privileged to experience, that experience meant more to me than any other achievement: to show my son who I am as a medical imaging professional and impress upon him the honor of serving our profession.” •

BRANDON A. SMITH

Who has had the biggest influence on your life? My paternal grandfather, Robert L. Smith Jr. remains the most influential person in my life. He passed away in 2018 but instilled a foundation focused on being accountable for myself and others, never settling for mediocrity, and giving without expectations in return.

MBA., MSRS, RT (R)(VI), CIIP, Radiology Applications Specialist What is the last book you read? “Stick Together: A Simple Lesson to Build a Stronger Team, The Go-Giver, and The Code of the Extraordinary Mind” Favorite movie? Disney’s “Coco.”

What is something most of your coworkers don’t know about you? I love to collect unique and rare Tequilas.

Who is your mentor? Dr. Michael Ward What is one thing you do every morning to start your day? As simple as it sounds, the first thing I do every morning is make my bed. No matter if I am at home or traveling for work, it sets my day in motion.

Best advice you ever received? You will never live the same second twice. Invest more time than you spend. Be mindful to what and who you give your time. Do so meaningfully.

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Nominate a peer at theicecommunity.com/nominations.

What would your superpower be? Seeing that I already kind of have X-ray vision, I’ll go with controlling the elements. I think it gives me options and some bonus abilities because of my primary superpower.

What are your hobbies? I enjoy competitive tennis, a heated game of monopoly, collecting books, fishing (although I am allergic to fish), card games and Mardi Gras!

What is your perfect meal? I can eat gumbo year-round! As a Southeast Texas/Southwest Louisiana native, I mean real gumbo. The more cayenne, the bigger my smile!

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1 2 3 Register online to view our live webinars each month.

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Watch recorded webinars online.

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RISING

STAR

SUMMER POWERS

BY ERIN REGISTER

S

ummer Powers, B.S.R.S, ARRT R.T.(R), is from Jenkins, Kentucky, located in the foothills of the Appalachian Mountains.

Her interest in the radiology field peaked when she needed to have an ultrasound as a senior in high school. She has been ARRT-registered since 2002 and in the field as a student since 2000.

ICE learned more about this “Rising Star” in a recent interview with Powers.

Q: Why did you choose to get into this field?

A: After researching how to become an ultrasound tech, I discovered that the field of radiology had many pathways. This was when I knew radiology was my field, I have done both diagnostic radiology and CT over the many years in my career.

Q: What do you like most about your position?

A: I am happy in my current role as a staff rad tech. I have the opportunity to help the new students as they do rotations at our facility and help new employees navigate the systems that are in place at the different facilities I have been employed.

Q: What interests you the most about the imaging field?

A: What interests me the most being in this field this long is the way technology is changing the field. I started in this career when darkrooms and film were in use, then advanced to daylight processing with CR and now to digital. As technology advances, we must change our approach for how we care for our patients.

Q: What has been your greatest accomplishment in your field thus far?

A: My greatest accomplishment is being recognized outside of work and thanked by a patient, knowing that I helped someone in their most difficult, and possibly the scariest time, of their life. • Nominate a Rising Star at theicecommunity.com/nominations

FUN FACTS • Favorite Vacation Spot: Any beach! We do spend a lot of vacations in Daytona and Destin, but any beach is good to me.

• Favorite Food: Cannolis • One Thing on Your Bucket List: The one thing on my bucket list is to travel to Italy. I want to see the small towns by the seaside and the old architecture of the city and sit outside a small cafe and have a glass of wine and a cannoli.

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SPOTLIGHT

Off Clock THE

PATRICIA HAMMER

BY MATT SKOUFALOS

I

n the seemingly endless cycles of novel coronavirus (COVID-19) peaks and valleys, there are few health care professionals who haven’t been called upon to give everything they have to keeping things running. Despite that relentless pressure, which has lasted 18 months and counting, they’ve continued to rise to the moments with which they’re met.

By the same token, however, workplace burnout is real, and just as uncompromising as the virus behind it.

“A lot of people don’t realize that the environment for imaging professionals is still very, very hard,” said

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X-ray technologist Patricia Hammer.

“COVID isn’t as traumatic as it used to be for us, but it’s still very tangible, and every time numbers spike up, it’s a real kick to the gut.”

“We already did a lot of chest X-rays, but every single patient, we have to X-ray them multiple times a day, and multiple days of the week,” she said. “It’s very taxing. I don’t know if society really understands what hospitals are dealing with right now. Everybody worked through the pandemic, and now we’re still working, and we’re tired.”

In an attempt to mitigate the impact of COVID burnout, Hammer switched over from working full-time to a per-diem schedule split between Community Medical Center in Toms River, New Jersey, and Atlantic Medical Imaging,

which has 16 offices throughout southern and central New Jersey. Recapturing some of her daylight hours gave Hammer more time with her daughters, aged 3 and 12, but it also gave her important time to tend the property at her Toms River home.

“From an imaging standpoint, we spend a lot of time in the dark,” Hammer said. “We’re in the basement, or in the middle of the building, surrounded by lead walls and concrete. We don’t see the sunlight until our break when we walk to our car, and there’s an ache there, when you have a job like that, for sunlight and grounding on the earth.”

“I crochet, I paint, draw; I like to play and learn songs on the ukulele, but if I’m not caring, feeding, and entertaining my family, you’ll find me

ADVANCING THE IMAGING PROFESSIONAL

in the garden,” Hammer said.

Throughout her childhood, Hammer recalled learning about the importance of carrying an ecological conscience into the world, “and how we had to try harder,” a lesson that’s stuck with her as she planned how she would cultivate her homestead.

“There’s just something that motivates me to live as gently as possible, because in 20 years, I don’t want my children or even grandchildren saying, ‘Why didn’t you do something?’ ” Hammer said. “That’s a responsibility that I don’t want. That’s a big motivator in the way that I do the things I do and why I do them.”

“I’m also trying to teach my daughters as well,” she said. “If I impart this knowledge upon them, it will be easier for them to have a sustainable life.”

Among those intentions, Hammer has done the work to create a registered wildlife habitat on her land, which means maintaining the property with sustainable practices (no pesticides, no chemical fertilizers); offering shelter for animals to hide, hunt or take cover from the elements; and providing food, water and a place to raise their young.

Perhaps more impressively, she’s taken a fraction of an acre of sandy Jersey pinelands and stocked it with native and companion plant species that attract beneficial bugs, support one another in balance, and foster the local native ecosystem.

“I have two extremes on my property: the front yard’s all sun, the backyard’s all shade,” Hammer said.

“When we moved in, there was a lot of erosion because we have a ravine on the back of our property. I have these things working against me, and

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I don’t want to fight them.”

“I have a clover lawn; in the springtime, there’s flowers and bees everywhere,” she said. “In the summertime, there’s sequential blooming throughout the season, so I have flowers all the time. We’ve got several species of milkweed to foster the monarch butterfly population and dill weed for swallowtail butterflies.”

Getting to this point hasn’t been easy. It’s taken Hammer three years of working through the seasons to get

PATRICIA HAMMER the results she’s seen by now, adding new species to the garden multiple times per year. But the rewards are meaningful. Her vegetable garden has yielded “too many tomatoes to count,” pumpkin vines, grapevines, black-eyed Susans, echinacea; even a watermelon plant spilling out of her compost tumbler. A raspberry patch on the side of the house got her children interested in picking berries right from the plants and popping them in their mouths.

“People plant flower gardens in their front yard; I’m planting sage,

and some daisies, and oregano, and thyme, and an almond tree,” Hammer said. “Not only are they delicious, but they have flowers that all the native bees and butterflies love.”

Hammer confesses that not everyone understands what she’s up to. She once told a colleague how healthy compost is for the planet; that colleague replied that she doesn’t recycle because she feels bad making the garbage haulers come to her house twice a week.

Undeterred, Hammer said she’ll work to set a good example while helping those who can benefit from her insight.

“If someone asks my opinions, I help,” she said. “I’ve donated seed collections and plant cuttings and instructions about where to plant to a coworker. Now he’s letting me know when he sees bargains on plants certain times of the year. It’s nice to branch out to these people who are trying the same way I am, and with even more knowledge.”

Beyond transforming her home into a wildlife habitat, feeding her family, and pushing back against the degradation of the planet, gardening is a meditative practice that Hammer said leaves her feeling “absolutely renewed” just by engaging in it. The moments she spends out of doors are some of her most treasured; they underpin a day marked by intense demands, and provide a necessary respite from the relentless pace of the pandemic.

“I tend to rush when I do things, but gardening makes me stop, think, plan, wait, and then, when a seed grows, it’s very validating,” Hammer said. “It’s often hard in this world to slow down and have gratitude for life, and I think gardening really does force me to do that.” •

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SPOTLIGHT

Rad idea STUDY: BIRDS, NATURE BOOST HEALTH

BY JOHN WALLACE

D

istractions can be work enemy number one – even the ones that seem to be important! One obvious reason to try and avoid or prevent distractions while at work is to become the most efficient employee possible.

However, there are other reasons. Distractions can also create stress and anxiety.

A short walk outside can do wonders for one’s state of mind. Fresh air, sunshine (vitamin D) and connecting with nature are great reasons to schedule a break during one’s workday. I was the editor of a newspaper about 20 years ago and stumbled upon this great tool for stress relief. I would go to the community college and feed the ducks at the pond. After just a few minutes I could feel the weight being lifted from my shoulders. A few deep breaths added to the sense of relief.

A recent study found that spending at least 120 minutes a week in nature is associated with good health and wellbeing. The study is available at https://tinyurl.com/ sttn2sbp.

A 2020 University of Exeter study, focused on nature’s impact on humans in suburban and urban areas, found lower levels of depression, anxiety and stress were

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associated with the number of birds people saw during afternoons at home. The benefits of birdwatching come from seeing lots of birds – quantity not “quality” – the study found.

People “felt relaxed and connected to nature when they watched birds in their gardens,” researchers said.

These feelings increased with the level of bird feeding in the yard. For millions working and schooling from home, this stress reduction was an unintended bonus.

In addition, an article on the American Psychological Association website quotes Lisa Nisbet, Ph.D., a psychologist at Trent University in Ontario, Canada on the matter.

“There is mounting evidence, from dozens and dozens of researchers, that nature has benefits for both physical and psychological human well­being,” says Nisbet, who studies connectedness to nature. “You can boost your mood just by walking in nature, even in urban nature. And the sense of connection you have with the natural world seems to contribute to happiness even when you’re not physically immersed in nature.”

Find out more at apa.org/monitor/2020/04/nurtured-nature.

Email your RAD IDEA to editor@mdpublishing.com.

ADVANCING THE IMAGING PROFESSIONAL

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All other trademarks are the property of their respective owners.

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NEWS

Imaging A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

KA IMAGING’S REVEAL 35C IN WHO COMPENDIUM

KA Imaging’s Reveal 35C has been included in the World Health Organization’s (WHO) compendium of innovative health technologies for low-resource settings, launched August 31, 2021.

This compilation features emerging technologies assessed and found to potentially improve health outcomes, the quality of life, or offer a solution to unmet medical needs. The WHO performs technical, health technology, regulatory system, quality system, management, and safe use assessments.

The information provided is manufacturer-reported and meant to inform professionals in the medical field about the advantages and challenges involved with implementing innovative health technologies in low-resource settings.

This fifth edition of the compendium prioritizes the need for COVID-19 response and other current health issues.

Reveal 35C is the world’s first portable dual-energy X-ray detector. It has both USA FDA 510(k) clearance and a Health Canada Medical Device License.

It is currently being used at two clinical sites in Canada, with promising early results. The application for use screening COVID-19 pneumonia is of particular significance now.

News

ENDOSOUND GRANTED BREAKTHROUGH DEVICE DESIGNATION

Endosound Inc. announced that its EndoSound Vision System received a Breakthrough Device Designation from the U.S. Food and Drug Administration (FDA).

The EndoSound Vision System is an add-on device that consists of a compact ultrasound beamformer, reusable transducer and disposable mounting kit that fastens onto any flexible upper gastrointestinal (GI) video endoscope to convert it into an endoscopic ultrasound (EUS) system. Its unique distal attachment allows the endoscopist to perform advanced procedures, such as fine needle biopsy, with precision, but without the controversial elevator mechanism found on most other linear echo-endoscopes.

In recent years, multi-use endoscopes that feature an elevator mechanism have faced scrutiny due to their association with patient infection risk. In a July 2020 Safety Communication published by the FDA, it was stated that “FDA recommends health care facilities and manufacturers begin transitioning to duodenoscopes with disposable components” to address the challenges presented by the elevator mechanisms on these endoscopes. Major device manufacturers have consequently responded with new disposable duodenoscope models, but the similarly designed ultrasound endoscopes have been overlooked. The innovative EndoSound Vision System addresses this oversight by eliminating the need for the elevator mechanism while still maintaining the precision and imaging that is necessary for complex EUS procedures.

The FDA Breakthrough Device Designation expedites the development and evaluation of novel devices that offer the potential to enhance patient outcomes through more effective treatment or improved diagnosis of life-threatening conditions. Under the program, the FDA will provide EndoSound with the opportunity to provide its feedback during the pre-market phase and prioritized review of the device submission.

For more information, visit kaimaging.com.

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ADVANCING THE IMAGING PROFESSIONAL

SYNTHETICMR, PHILIPS INK AGREEMENT SyntheticMR has entered an agreement with Philips to include SyntheticMR’s medical imaging solution in its global product catalog. The agreement means that SyntheticMR’s solution SyMRI NEURO will be included

in Philips’ third-party product catalogue and enables Philips to offer the complete package to its customers.

For more information, visit syntheticmr.com.

UNITED IMAGING UCT ATLAS EARNS FDA CLEARANCE United Imaging has announced FDA clearance for the uCT ATLAS, the latest in the company’s computed tomography (CT) portfolio of scanners and the 25th FDA clearance for the company overall.

“I am incredibly excited to bring this equipment to market in the U.S.,” said David Bradley, vice president of sales and business development. “To say that the uCT ATLAS is a workhorse is an understatement – it is a true powerhouse. In the end, image quality is what matters the most, and the images from the uCT ATLAS are absolutely exquisite. In addition, our AI-empowered workflow coupled with our uExceed software platform should please any technologist who touches this system. This could easily be the busiest scanner in the entire department.”

Bradley went on to note that the core innovations of the uCT ATLAS, such as Z-Detector architecture, low dose capabilities, and workflow innovations, are featured in all of United Imaging’s CT scanners. This enables customers to image a wide variety of patient and exam types, such as pediatric, CT angiography (CTA), patients with metal implants, and cardiac examinations. All advanced applications and post-reconstruction analysis software, and complete investment protection with Software Upgrades for Life, are also standard across United Imaging’s CT portfolio.

The uCT ATLAS is specifically designed to max-

imize clinical flexibility. Among other features, the ultra-wide 82-cm bore and 700 pounds table weight capacity facilitates the comfortable scanning of large patients and excels in the trauma environment. The uCT ATLAS features an integrated uAI Vision 3D camera that enables an AI empowered workflow, offering operational efficiencies that make the most complex exams the simplest to perform. The speed of a large area coverage system coupled with a 0.25 second gantry rotation makes it easy to image pediatric and trauma patients as well as patients with compromised breathing. The onebeat coronary CT solution allows users to confidently perform coronary CTA scans. In addition, low dose technologies such as 60 kVp scanning capability, uAI AI-IR and KARL 3D reduce radiation dose while maintaining image quality. The uCT ATLAS will help health care providers champion new exams, perform existing exams with more confidence, and ultimately provide greater clinical flexibility.

INTELERAD PARTNERS WITH STRATEGIC RADIOLOGY Intelerad Medical Systems and Strategic Radiology have announced a partnership to provide Strategic Radiology’s more than 1,300 members with access to cloud-based medical image management solutions designed to optimize performance, optimize workflow and improve patient care.

As a result of the new partnership, member groups of all sizes can now leverage Intelerad’s InteleOne XE cross-enterprise diagnostic imaging platform and nuage Cloud Imaging Platform, including its picture archiving and communication system (PACS) IntelePACS, and Clario SmartWorklist, a personalized and context-aware enterprise imaging solution designed to intelligently manage reading workflow. These solutions

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are becoming critical to helping radiologists improve interoperability, create more efficient workflows and address the prevalence of burnout.

Strategic Radiology members can choose between two models for leveraging Intelerad solutions. The first model features a shared environment that grants practices the SR Enterprise License to join other members; practices choosing this model benefit from significant scale along with the peace of mind that their data is private and secure within Intelerad’s hosted environment. The second model provides practices with an Individual Practice License.

All users will have access to Intelerad Managed Services, which includes turnkey access to the necessary software, hardware, and cloud support of all solutions.

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NEWS RSTI, ALTHEA OFFER CONTRAST INJECTOR TRAINING COURSE RSTI has launched a new contrast injector training course available on-site at your location or at its training facility in Solon, Ohio with Althea faculty.

This unique course will equip biomedical and imaging technician professionals with the skills and knowledge they need to perform preventative maintenance and troubleshoot contrast injector system failures and restore them to operation.

“RSTI is committed to providing their students with the best biomedical and diagnostic imaging service training available. We’re excited to bring Althea’s contrast injector training to our facility and provide students with the opportunity to learn from a leader

in the industry,” says Todd Boyland, CEO, RSTI. The course is taught by Michael Gossman, injector modality manager, Althea Group, with curriculum centered around five main pillars: knowledge of operation; operational functions; on-the-spot repairs; parts replacement; and preventative maintenance.

This course is tailored to fit the students’ individual needs. Students will train on a minimum of two contrast injector models per session with the option to train on up to four.

For more information, visit rsti-training.com/courses/contrastinjector-training.

ATLANTIC STREET CAPITAL INVESTS IN PRESTIGE MEDICAL IMAGING Atlantic Street Capital (ASC), a private equity firm targeting entrepreneurial businesses poised for the next level of growth, consummated a partnership with an investment in Prestige Medical Imaging (PMI), the largest independent radiology service and solutions provider in the Eastern United States.

Founded in 2003 and headquartered in Newburgh, New York, Prestige

Medical Imaging is a medical imaging solutions company providing equipment service, maintenance and support to hospitals, physician practices, ASCs and sports teams across the United States. Key products represent a broad suite of medical imaging equipment including X-ray machines, mammography systems, CT scanners, ultrasound machines, MRI systems and surgical C-arm

systems. Customer practice specialties include orthopedics, radiology, pulmonology, veterinary, urology, podiatry, urgent care centers and professional sports teams. PMI is the official X-ray equipment provider of the NBA and several professional sports teams.

For more information, visit www.prestigemedicalimaging.com

BUTTERFLY IQ PORTABLE HANDHELD ULTRASOUND SYSTEM USED IN SPACE The Translational Research Institute for Space Health (TRISH) has announced the success of a medical imaging technology demonstration aboard the International Space Station (ISS). During space exploration missions, the medical kit must feature tools with reduced mass and enhanced and self-reliant usability by the crew. Astronauts tested use of the Butterfly iQ – a handheld single-probe ultrasound system that connects to a mobile device – without any ground support. The device is seen by many as a quintessential tool to augment medical care in future space missions.

The Butterfly iQ is the world’s first handheld, single-probe scanner with semiconductor ultrasound transducer technology (Ultrasound-on-Chip) developed

by Butterfly Network Inc. The product’s first user demonstration in space was conducted by NASA Johnson Space Center’s Space and Clinical Operations Division through its

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Strategic Technology Advancement Process (STAP) with support from TRISH and Butterfly Network.

An imaging capability would be an obvious enhancement for crew health care during future flights, such as NASA’s Artemis missions. Advanced tools, however, often exceed the modest mass, volume and power allocations of the constrained spacecraft. This two-phase demonstration sought to establish whether Butterfly iQ’s probe technology and intuitive, smartphone-based application comprise an effective model for meeting the challenge.

This was the first mission to take Butterfly iQ to space, with participation of NASA, TRISH, KBR, and Butterfly Network. The Butterfly iQ+ was flown on Sept.

15 aboard SpaceX’s Inspiration4, the first all-civilian flight to orbit Earth. On that mission, participants conducted a number of successful foundational experiments using the Butterfly iQ.

ADVANCING THE IMAGING PROFESSIONAL

SPINE CENTERS ADOPT DYNAMIC DIGITAL RADIOGRAPHY Dynamic Digital Radiography (DDR) from Konica Minolta Healthcare Americas Inc. is rapidly gaining acceptance in spine centers across the U.S. because of its ability to capture the physiological motion of the cervical spine (C-spine) and lumbar spine (L-spine) as a patient moves through the full range of motion.

More than 10 spine and orthopedic centers have implemented DDR on the KDR Advanced U-arm System in 2021. DDR first gained acceptance in hospitals as a tool for pulmonologists to assess and quantify lung function. As orthopedic and sports medicine specialists gained exposure to the technology, DDR has been adopted in all types of facilities, from academic centers to community hospitals and large and small orthopedic and spine practices.

Neill Wright, MD, a cervical spine expert and neurosurgeon with Blessing Physician Services, part of Blessing Health System (Quincy, Illinois), says DDR is filling an important diagnostic need in patients with

injuries to their neck.

“There are limitations with static X-rays, as we may not get a very accurate picture of what their neck is doing in motion,” Wright explains. “In patients complaining of significant neck pain where all traditional imaging has failed to show any problems, we are seeing with DDR what was not otherwise diagnosed. The exam is seamless, cost-effective and readily available as part of our normal radiographic workup.”

DDR is not fluoroscopy, it is a series of individual digital images acquired at high speed and low dose on the KDR Advanced U-Arm, a fully automated digital radiography system that can be used for all standard X-ray studies. In the same study, clinicians can acquire static and dynamic images. The resulting cine loop provides visualization of the dynamic relationship of anatomical structures in a diagnostic-quality view. Motion quantification is possible with advanced image processing from Konica Minolta.

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21

NEWS

PROBEHUNTER TESTS OLYMPUS ENDOSCOPY ULTRASOUND BBS Medical has released an adapter that allows its ProbeHunter to conduct dynamic testing and validation of the performance of Olympus Endoscopic Ultrasound that utilizes advanced features for imaging, sampling and interventional EUS/EBUS procedures. This is the latest addition to the company’s probe testing capabilities.

“This means that we can include Olympus to the adapter portfolio and to the adapter list of all leading OEMs’ ultrasound probes – GE, Philips, Siemens, Samsung, Mindray and more – to test independent from the system, on ProbeHunter,” says BBS Medical CEO Björn Segall.

“With 50 different multi-brand adapters in our portfolio, we can offer hospitals and anyone dealing or servicing ultrasound probes the ultimate tool for patient safety,” he adds.

ProbeHunter is a multi-brand real-time testing device with innovative technology designed to provide quality assurance for ultrasound probes. It is designed for patient safety, for the user to get a super quick “Go or No Go” before using a probe on a patient.

“It is now easier than ever to get a ProbeHunter system,” adds Segall.

“The Swedish government supports export business and is offering a capital credit guarantee during the pandemic. It means, in general, that it is possible to have a ProbeHunter system today and pay later. I would like to encourage hospitals and the ultrasound probe industry to make use of this unique possibility for patient safety.”

WHITE PLAINS HOSPITAL ACQUIRES PET/MR White Plains Hospital recently aquired a PET/MRI scanner. White Plains Hospital is the first and only health care facility in the Hudson Valley and Fairfield County to have this new technology. PET/MRI scans combine the anatomical accuracy of MRI with the metabolic information of positron emission tomography (PET) to provide exceptional image quality, shorter test times and lower radiation exposure for patients.

According to Dr. Andre Khoury,

co-director of radiology at White Plains Hospital, the new PET/MRI scan is the latest state-of-the-art tool to improve the health of the community.

“PET/MRI screening is on its way of becoming the gold standard for detecting a range of diseases in their earliest stages. It’s rare to see this level of technology at a community hospital, but it’s indicative of our commitment to expand access to advanced care, close to home. Since acquiring this scanner,

we have had requests from physicians throughout the region who understand the amazing capabilities of PET/MRI and want their patients to come in to be evaluated,” Khoury said.

The PET/MRI scanner is one of many advanced health care services offered at White Plains Hospital’s new Center for Advanced Medicine & Surgery (CAMS). CAMS opened in early June 2021 and is a 252,000-squarefoot, nine-story outpatient center.

PERLIN NAMED PRESIDENT OF THE JOINT COMMISSION The Board of Commissioners of The Joint Commission recently announced the appointment of Dr. Jonathan B. Perlin to lead The Joint Commission as its next president and CEO. The appointment is effective March 1, 2022.

Widely known for his leadership in healthcare quality and information technology, Perlin is currently president, clinical operations and chief medical officer of Nashville, Tennessee-based HCA Healthcare, one of the nation’s leading providers of health care services.

At HCA, Perlin leads a large team of clinicians and data scientists in setting clinical and professional

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policy, implementing clinical data tools, and improving care outcomes. His team was the 2019 recipient of the John Eisenberg Award for National Innovation for enhancing sepsis detection and survival.

“Dr. Perlin is a leader in quality and patient safety as demonstrated in his distinguished career,” says Michael Suk, MD, JD, MPH, MBA, FACS, chairman of The Joint Commission Search Committee. “He is well positioned to lead The Joint Commission into the future with intelligence and vision as the organization continues its mission to continuously improve the safety and quality of care provided to the public.”

ADVANCING THE IMAGING PROFESSIONAL

FDA CLEARS SOMATOM X.CEED PREMIUM SINGLE-SOURCE CT SCANNER Siemens Healthineers has announced the Food and Drug Administration (FDA) clearance of the SOMATOM X.ceed, a single-source computed tomography scanner that combines high-speed scanning capabilities and a level of resolution previously unseen in other single-source CT systems with a new hardware/software combination to simplify CT-guided interventions. Possessing the largest bore for a diagnostic CT scanner at 82 cm, the scanner is designed for all diagnostic procedures, particularly cardiac and trauma imaging.

“With these and other features, the SOMATOM X.ceed expands precision medicine and transforms care delivery,” a news release states.

“Several key design features of the SOMATOM X.ceed differentiate it from other single-source CT scanners. It has the fastest rotation speed¹ on a single-source CT at 0.25s to ensure a high native temporal resolution and reduce motion artifacts when scanning moving structures such as the heart,” the release states. “It possesses the fastest scan speed¹ at 262mm/s for consistent image quality across the entire field of view. Additionally, the scanner has the smallest focal point¹, at 0.4x0.5, for increased spatial resolution to better aid in the detection of deep-seated small and medium lesions. And with 1300 mA power reserves, it also has the highest power, enabling a high level of image quality for larger patients while expanding the utilization of low dose and low contrast media techniques, such as low kV imaging.”

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A key feature of the SOMATOM X.ceed is myNeedle Companion, a new approach to CT-guided interventions that combines hardware innovations and intuitive software to coordinate the planning and guidance of percutaneous needle procedures. One version of myNeedle Companion includes myNeedle 3D, a fully integrated software package that supports complex interventional procedures and includes as an option the world’s first scanner-integrated laser guidance system. Established myExam Companion user guidance software employs artificial intelligence to help simplify and standardize scanner operation for each user. myExam Companion also provides a new decision tool for trauma imaging, and the new myExam Satellite feature allows immediate assessment of CT perfusion results, which can be valuable in emergency radiology.

“With the SOMATOM X.ceed, Siemens Healthineers expands its portfolio of high-end, single-source CT scanners that leverages the myExam Companion intelligent user interface to standardize and streamline workflows as well as provide optimal image quality at the lowest possible dose,” said Douglas Ryan, Vice President of the Computed Tomography business at Siemens Healthineers North America.

“The addition of myNeedle Companion can help healthcare professionals perform simple and complex interventional procedures with greater confidence. And the high image quality resulting from the scanner’s fast rotation and scan speeds, coupled with its high resolution, can help lead to more informed decisions.”

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23

RSNA

RSNA 2021 SHOWCASES TECHNOLOGY, DIVERSITY

T

he Radiological Society of North America (RSNA) recently announced highlights of the Technical Exhibition planned for RSNA’s 107th Scientific Assembly and Annual Meeting (RSNA 2021), to be held at McCormick Place Chicago, Nov. 28-Dec. 2, 2021.

“Over 500 companies have committed to exhibit at RSNA 2021 in Chicago,” said John P. Jaworski, C.E.M., RSNA director of meetings and exhibition services. “These companies are excited about returning to Chicago to safely meet face to face with their customers and provide a positive experience for RSNA attendees.”

IMAGING TECHNOLOGIES

RSNA 2021: Redefining Radiology will showcase new ideas and technologies that redefine what it means to work as a radiologist. With an abundance of science presentations and posters, education courses and exhibits, a live technical exhibition covering 336,400 square feet across two exhibit halls and a robust virtual exhibition, the meeting promises to deliver an outstanding program of research, education and cutting-edge technology for medical imaging pro24

ICEMAGAZINE | NOVEMBER 2021

fessionals from around the world.

As the world’s largest medical imaging conference, RSNA 2021 provides the ultimate show floor for demonstrating the latest medical imaging technologies in CT, MRI, artificial intelligence (AI), 3D printing and more. Currently, there are 510 confirmed exhibitors for RSNA 2021, including 71 first-time exhibitors.

The technical exhibition will feature the expansive AI Showcase and Theater, as well as the 3D Printing and Mixed Reality Showcase, the First-time Exhibitor Pavilion, Educators Row and Recruiters Row. Located in the South Hall, the RSNA AI Showcase, sponsored by AIRS Medical, annalise.ai and neurophet, features more than 100 companies covering nearly 34,000 square feet. Within the AI Showcase each day between 10:30 a.m. and 3:45 p.m., the theater will offer presentations on AI solutions that are helping to shape the future of imaging. Forty-two industry AI presentations are scheduled for the week.

From 4 to 5 p.m., sessions will highlight RSNA AI initiatives, including the RSNA Imaging AI Certificate program, the Medical Imaging and Data Resource Center (MIDRC) and AI Challenges.

This year’s AI Challenge award winners will be recognized in the AI Showcase Theater on Monday, Nov. 29 at 4 p.m.

Also in the South Hall, the Imaging AI in Practice Demonstration will showcase new AI technologies and standards to allow radiology practices to integrate AI into their workflow. A collaborative effort among industry partners and radiology and informatics professionals, the exhibit features 22 vendors demonstrating 35 individual applications. Using clinical scenarios and medical images to show AI tools and health information technology standards in action, the demonstration will follow the radiology workflow from imaging examination ordering through reporting and follow-up.

The 3D Printing and Mixed Reality Showcase in the North Hall will feature the latest products in 3D printing, advanced visualization, holography and virtual reality. Presentations and hands-on activities will spotlight the critical role that radiology plays in these exciting technologies.

Attendees interested in deepening their understanding of AI applications can visit the RSNA AI Deep Learning Lab, located in the Lakeside Center.

The lab will offer 14 unique sessions throughout the week covering a range of AI topics and skill levels. Many of the sessions will use a combination of lecture and hands-on activities.

RSNA 2021 features a wealth of industry programming throughout the ADVANCING THE IMAGING PROFESSIONAL

week, including corporate symposia, “lunch and learns,” virtual industry and product presentations, vendor workshops and AI Theater presentations.

DIVERSITY

One slate of programming promoting health care diversity, equity and inclusion is to be presented at the upcoming annual meeting.

RSNA 2021 presents a unique opportunity to shine a light on health care inequities, both domestic and international, and to provide insights, research and education on how to improve diversity and inclusivity in medical practice.

RSNA 2021 will offer more than 50 scientific presentations, lectures, courses and exhibits on diversity, equity and inclusion throughout the five-day meeting. Courses include “Moving Beyond the Gender Binary: Exploring the Gender Spectrum and Diversity in Patient Care, Education, and Research,” “Inclusion as a Key to Success of Diversity Efforts” and “Trailblazers in Health Equity: Lessons Learned & Leadership Opportunities to Advance Health Equity in Radiology and Beyond,” sponsored

by RSNA’s Committee on Diversity, Equity & Inclusion (CDEI).

“The COVID-19 pandemic cast a spotlight on health inequities throughout the world and the critical importance of diversity and inclusion,” said RSNA President Mary C. Mahoney, M.D. “From its diverse lineup of presenters, faculty and awardees to a program brimming with DEI-focused sessions, courses and exhibits, RSNA 2021 will highlight the important diversity and health equity issues affecting our profession – and the care of our patients – and offer expert guidance and tools for attendees to foster DEI culture and initiatives in their practices.”

Research presentations include “Impact of Race, Ethnicity and Insurance Status on Breast Cancer Mortality at a Safety Net Academic Medical Center,” “Racial Disparities in COVID-19 Associated Pulmonary Embolism,” and “A Telerobotic Ultrasound Clinic Model of Ultrasound Service Delivery to Improve Access to Imaging in Rural and Remote Communities.”

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Many of the offerings ask radiologists, educators and administrators to reflect on their own practices and improve diversity, equity and inclusion across all subspecialties of the medical imaging field. On Wednesday, December 1, radiation oncologist, Iris Gibbs, M.D., of Stanford, will present a plenary lecture on “Addressing the Continued Exclusion of Black Physicians in the US Radiation Oncology Workforce.”

RSNA’s strategic plan includes the crucial goal of promoting diverse representation within the profession and ensuring diversity in RSNA leadership.

RSNA was the first radiology organization to require unconscious bias training for all committee chairs, editorial board members and program planners, and to issue requirements for selection of leadership positions. Through conscious selection of faculty, leaders and representatives, RSNA seeks to amplify a diverse set of voices.

RSNA’s commitment to inclusivity extends to all events the society hosts.

It is the society’s core belief that the greatest benefits to the medical imaging community for the exchange of science and education are achieved when all parties can fully and freely engage one another. RSNA recently formalized its commitment to provide a safe space for all participants

in RSNA events and activities and to encourage a culture of allyship with its welcoming environment statement.

To foster an inclusive and productive annual meeting experience for all, RSNA annually offers Camp RSNA, an onsite daycare facility at McCormick Place. Open to children ages six months to 12 years, Camp RSNA will follow state and local health regulations and current CDC guidance for operating childcare programs, providing a safe environment with a creative, customized schedule of events and a variety of engaging, age-appropriate activities led by trained professionals.

The service is offered at no cost to RSNA members and is available to nonmembers for a nominal fee.

RSNA is working closely with the city of Chicago and McCormick Place to provide a safe and comfortable experience for exhibitors and attendees.

RSNA will require proof of vaccination from all meeting attendees and exhibitor personnel, and face coverings must be worn inside the venue. McCormick Place has enhanced its air quality and cleaning procedures and has received multiple accreditations for maintaining a safe and hygienic environment. Some larger exhibit hall aisles have been added to the floor plan, including areas near anchor exhibitors. Hand sanitizing stations will be available throughout the exhibit halls.

RSNA 2021’s virtual meeting component will offer exhibitors the opportunity to reach virtual meeting attendees through the online exhibitor listing. This year, the online exhibitor listing has been modified to serve both in-person and virtual attendees and exhibitors.

Additional virtual platform features available to exhibitors wanting to connect with the virtual audience include interactive booth demonstrations, live one-on-one chat and expanded company information.

For more information, visit RSNA.org.

ICEMAGAZINE

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NEWS

ICE

A COOL SERIES FOR HOT TOPICS

PRESENTERS DELIVER IMAGING INSIGHTS STAFF REPORT

T

he ICE Webinar series is nearing the 1,000 registrations mark in 2021.

The series continues to grow more popular as it delivers valuable information to imaging professionals. The sessions also provide a way for professionals to earn ARRT Category A CE credits.

CONTRAST INJECTOR TROUBLESHOOTING

The recent ICE webinar “Troubleshooting Basics for Bayer/Medrad Contrast Injectors” was sponsored

by Althea and approved for 1.0 ARRT Category A CE credit by the AHRA (AHRA Reference: LEC11420; Expiration Date: 10/6/2022).

In this 60-minute webinar, Modality Manager Michael Gossman provided basic troubleshooting procedures for common Bayer/Medrad Contrast Injectors. He provided an explanation of error codes, most common unit failures and an overview on how to correct these errors on the five primary Bayer/ Medrad injector models.

Gossman provided additional in26

ICEMAGAZINE | NOVEMBER 2021

formation in a question-and-answer session.

One attendee asked, “When looking at the error codes and possible causes, how accurate are the probable causes?”

Gossman said the error codes usually “get you in the ballpark.”

Another good question was, “How do you troubleshoot the Solaris EP injector when the injector head is in the MRI scan room?”

Gossman explained how the work is done outside of the MRI room.

The webinar was well attended with almost 100 attendees at the live presentation. A recording of the webinar is also available for on-demand viewing.

Attendees provided feedback on the webinar via a survey that included the question, “How well did the content that was delivered match what you were promised when you registered?”

“Yes, the basic troubleshooting techniques covered what is needed to quickly remedy the problem. The best tip was that batteries cause the most problems for the Solaris,” said R. Johnson, BMET.

“Very well; I have a good idea of what kinds of errors may occur and how to diagnose/treat them,” said J. Tirado, clinical engineering.

“I was not expecting you to cover 5 models of injectors! That was awesome. I was thinking 1 or 2 could be covered in that time frame,” said B. Judah, senior biomedical equipment technician.

AI AND IMAGE PROCESSING

The ICE webinar “AI in Action – Taking Image Processing to New Heights” was sponsored by Carestream and approved by AHRA for 1.0 Category A ARRT. (AHRA Reference: LEC11386; Expiration Date: 9/15/2022) In the webinar, experts Lori Barski, Ron Muscosky and Jim Sehnert discussed image processing capabilities that utilize AI to provide better image quality to help radiologists deliver a higher level of patient care.

AI is a hot topic these days and is used in all aspects of everyday life.

From ordering a meal through an app on one’s phone to getting driving directions to a vacation destinaADVANCING THE IMAGING PROFESSIONAL

tion, AI is there. It is the same for radiology. AI is helping improve workflow efficiency and productivity. It can also provide clearer, more pristine images for better diagnostic confidence.

More than 60 imaging professionals registered for the webinar. It received positive feedback via a post-webinar survey that includes the question, “How will today’s webinar help you improve in your role?”

“It has given me great insight into the role and benefits of AI in image processing,” Mammography Care Coordinator A. Harris said.

“What to expect to see from our radiologists in the near future!” Imaging Technologist K. Hall said.

“Better understanding of tools and processes that can help the clinical side is always a benefit,” Clinical Engineer K. Ferguson said.

Thank you sponsors!

For more information, visit ICEwebinars.live.

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ICEMAGAZINE

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PRODUCTS

Market Report

Nuclear Medicine Market Faces Challenges STAFF REPORT

M

ordor Intelligence recently issued a report regarding the nuclear medicine market that states that the North American nuclear medicine market was valued at $5.6 billion in 2020 and is projected to be worth $10.2 billion by 2026 registering a compound annual growth rate (CAGR) of 10.4%, over the forecast period 2021-2026.

“Several general principles have been implemented by government organizations with key goals to reduce disease transmission, preserve health care system functioning, protect health care workers, and ultimately reduce mortality and morbidity. A new set of regulations for the protection of the staff in the imaging centers and other nuclear facilities were rolled out. In 2020, the United States Food and Drug Administration (FDA), has developed guidelines to assist nuclear medicine departments to change operating procedures to reduce the risk of COVID-19 infection among patients, staff and the public.

According to Jason J. Naidich’s article “Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Imaging Case Volumes,” published in May 2020, total imaging volume in the first half of 2020, declined by 12.29% compared with 2019 in New York. Post-COVID-19 emergence revealed a greater decrease (28.10%) in imaging volumes across all patient service locations and modality types. This suggests the nuclear imaging with other imaging techniques had a decrease effecting the market size and trend.

The North American nuclear imaging market is expected to witness significant growth owing to the technological advancements, rising burden of diseases and adoption of nuclear medicine in therapeutics as well as diagnostics, according to Mordor Intelligence.

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Government initiatives and funding for the development of new techniques are estimated to drive the nuclear medicine market. For instance, in July 2019, a new bill named Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 was passed by the U.S. government. The new bill aims to extend access to high-targeted, and more precise treatment and diagnosis of severe neurological diseases, by changing the way of Medicare payments for imaging services.

The growing funding for research and developments in Canada is also expected to boost market growth. For instance, in May 2020, ARTMS Products, a Vancouver based startup raised CAD 26.4 million Series A funding which helps in research and production of radiopharmaceuticals “The technological advancements in the field of imaging have boosted the market growth. Over recent years, scientists, researchers and technologists have been able to bring hybrid systems in clinical practice, in which two or even more than two standalone diagnostic imaging modalities are combined. There are many technological advancements, like the introduction of time of flight (ToF) and the increasing popularity of hybrid imaging systems, which play an important role in the growth of the market studied,” Mordor Intelliegnce states.

However, high cost of the diagnostic and therapeutic equipment and procedures have been acting as restraints to the growth of the market studied, the report adds.

“The nuclear medicine market is projected to reach $7.5 billion by 2026 from $4.8 billion in 2021, at a CAGR of 9.0% during the forecast period,” MarketsandMarkets reports.

“Growth in the nuclear medicine market can primarily be attributed to factors such as the increasing incidence and prevalence of cancer and cardiac ailments and initiatives to lessen the demand-supply gap of Mo-99. However, the short half-life of radiopharmaceuticals reduces their potential adoption, while hospital budget cuts and high equipment prices are expected to limit market growth to a certain extent.” • ICEMAGAZINE

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PRODUCTS

Product Focus Nuclear Medicine

DIGIRAD

Cardius X-ACT+ Nuclear Gamma Camera The Digirad X-ACT+ is a groundbreaking, SPECT/FAC camera that offers more accurate test results, true attenuation correction, cardio-centric imaging, less radiation dose to the patient, and does this while reducing the cost burden to the health care system. With its optimized, solid-state, triple-head design, the X-ACT+ can complete emission and transmission data acquisitions without repositioning the patient. With industry-leading sensitivity to provide high-quality, high-count rate exams, the X-ACT+ also features solid-state detectors, rapid imaging detector geometry, fully integrated low-dose fluorescence x-ray attenuation correction, advanced 3D-OSEM reconstruction techniques, patient satisfying ergonomics, TruACQ Count Based Imaging and over-the-air updates on demand.

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ICEMAGAZINE | NOVEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

GE HEALTHCARE StarGuide

GE Healthcare recently unveiled StarGuide, a next-generation SPECT/CT system that uses the latest digital technologies to help clinicians improve patient outcomes in bone procedures, cardiology, neurology, oncology and other medical specialties.

The system’s cutting edge 12 CZT Digital Focus Detectors not only scan patients in 3D to provide more information to clinicians but they are also optimized for Theranostic procedures, which combine the delivery of therapy to patients with diagnosis to monitor disease.

SIEMENS HEALTHINEERS c.cam

The c.cam dedicated cardiac single-photon emission computed tomography (SPECT) scanner from Siemens Healthineers has a reclining patient chair with a 450-pound weight limit, rather than a flat table, to allow the patient to remain seated comfortably during scanning, minimizing respiratory motion and cardiac image artifacts.

The integrated, bi-directional camera arm permits easy patient positioning, and the small field of view is optimized for cardiac procedures. The enhanced cybersecurity features of the Windows software platform limit access by non-authorized personnel. And with a small 8 foot by 8 foot footprint, the c.cam can be installed in just two days with minimal room modeling requirements.

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ICEMAGAZINE

31

Find a Partner Managing Disparate Needs to Improve HTM Outcomes

BY MATT SKOUFALOS

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ICEMAGAZINE | NOVEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

“ Whenever possible, we always encouraged a team approach, and that gave us an in-house partner. It takes people who have a collective goal to keep these things up and running.” –Nick Gaffey

I

n any health care organization, large or small, independent or network-affiliated, collaboration is the engine that drives success. Whether it’s in-house, among different divisions within a large hospital, or involves taking on external partners with the capacity to enhance the offerings on the ground, the relationships that produce the greatest results are those that fulfill institutional aims while also supporting the success of individual departments.

Nick Gaffey, head of OMI MedTech, an independent service organization based in Orlando, Florida, has seen the world of healthcare technology management (HTM) as both the operator of an independent service organization (ISO) and an OEM equipment support manager. Before establishing his own business, Gaffey worked as a service director at Omega Medical Imaging of Sanford, Florida, which manufactures artificial intelligence fluoroscopy/cine (AIF/C) imaging systems. His role there was to support the Omega Medical Imaging install base of AIF/C products across its customer sites, most of which had contracted with the company for a service plan.

In structuring those agreements, Gaffey said the company would create a “team assurance contract,” a tiered agreement that leverages in-house biomed teams as a first line of defense for systems maintenance and repairs. He described such an

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agreement as “really beneficial to both parties because we’re able to save the department money and also have boots on the ground.”

“I think it’s more efficient if HTM and imaging can work together, hand in hand, and form a strong partnership,” Gaffey said. “Whenever possible, we always encouraged a team approach, and that gave us an in-house partner. It takes people who have a collective goal to keep these things up and running.”

“What we got out of it was help when we needed it diagnosing issues, and keeping the system up and running and safe, and what they got out of it was a financial incentive and a knowledge of the room and the equipment,” he said. “What it did for the hospital, the [imaging] department, and the HTM group is put more money in their budget because the costs of any service agreement would be reduced. We also provided training along with that team assurance plan.”

When Gaffey founded OMI MedTech, he carried forward that same tiered approach to HTM with his own clients, seeking opportunities to partner with OEM vendors who need local service subcontractors with knowledge of their technology and access to his geographic region. At the same time, he works with standalone medical imaging facilities and institutional imaging departments who need the skills and services of a seasoned biomed. Keeping a foot in both worlds requires the ability to manage relationships with professionals who use the technology he services as well as those who develop it.

“You have to have the relationship and the trust, and then also have an in-depth, expert knowledge of the equipment you’re taking care of,” Gaffey said. “You build that trust by having the expertise and knowledge of the equipment. I’m using the knowledge I gained from my time at Omega, and trying to be flexible. That’s the name of the game in this business.”

In addition to his years of experience, Gaffey continues to establish that trust with his clients by delivering what they want and need, and not trying to sell them on things they don’t. Most of them want support training their in-house teams to repair and maintain their medical devices, or some financial incentive to add the extra layer of service his support crews provide. Given the variability of those needs, he tailors every service contract to the distinct needs of each client.

“Most of the time, imaging departments want to learn more about the system in the room, and we really value that onsite partner relationship,” Gaffey said. “In a lot of cases, it’s a winwin for everyone involved. We’re doing preventive maintenance and calibrations for these systems to keep them working to manufacturer’s specs, and a lot of biomed work. And if there’s an issue, we’ll come in and repair the issue.”

OMI MedTech also grew its business during the novel coronavirus (COVID-19) pandemic by being the local, on-theground partner that its clients needed when the pandemic ICEMAGAZINE

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shut down or severely limited widespread travel, which in many cases cut off departments in need of service from the OEM providers that would have dispatched technicians to support them. For those cases they couldn’t reach in person, OMI MedTech leveraged tele-coaching to help diagnose concerns and offer fixes.

“For a lot of local surgery centers that don’t have an in-house biomed or imaging team, we’re their in-house support,” Gaffey said. “We concentrate on the central and southwest Florida area, and dispatch same-day in most cases. That’s what our value is: if something happens, and the airport’s shut down, and you can’t get that OEM guy out, we’re going to be there.”

“With the pandemic making it harder to get onsite and to travel, we utilized a lot of video chats,” he said. “My guys never stopped traveling but having the ability to have someone onsite with a camera diagnosing issues and walking them through repairs was invaluable.”

Sometimes, however, forming those internal and external HTM partnerships that strengthen an organization may require overcoming a mismatch between institutional strategic initiatives — like cost-cutting – and taking the steps required to pursue these partnerships “As I’ve gone through different organizations, imaging department goals and priorities versus biomed and IT initiatives can be quite different,” said Nicole Dhanraj, systems director at Northern Arizona Healthcare in Flagstaff, Arizona.

“I’ve experienced being in a silo versus coming together with multiple stakeholders aligning the vision for my department with the visions of other departments,” Dhanraj said. “I think sometimes department heads unintentionally forget that they need to involve these other departments to pursue their desired initiatives, and to ensure everyone shares similar priorities that ultimately support the organizational vision.”

To Dhanraj, supporting the needs of her internal HTM partners need not conflict with the financial goals of her institution. Yet despite her interest in seeking out some ISOs to help drive savings, Dhanraj said she’s been met with reluctance amid concerns that anyone

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other than the OEM could manage those needs effectively.

“I feel like we have been brainwashed to think about OEMs as the only people available to manage our equipment,” she said. “When those [vendor] folks are onsite, and staff is forming relationships [with them] through equipment purchases, there is a sense of obligation and loyalty in combination with this indirect marketing. In some other cases, this is an unknown, and that in itself can paralyze us to move beyond OEM contracts.”

“In my years of experience, it’s been challenging from a front-line perspective to break that apprehension; to get staff to be open and understanding about having these other partnerships,” Dhanraj said. “From an organizational perspective, generally senior leaders are afraid to go head-on with these OEMs and bring in third-party vendors because they’re fearful that they won’t get a service manual, or a firmware/software upgrade, or just move outside of traditional practices.”

Although Dhanraj has offered this suggestion as some equipment service contracts are set to expire, she has encountered a comparable degree of institutional hesitation despite the potential for “significant savings” on the table. Fear of the unknown – or of losing revenue to equipment downtime, trying a service other than OEM – is a real obstacle to trying out a new partner. Questions about whether an ISO could capably manage issues related to common, proprietary OEM concerns, such as access to technical manuals or equipment service codes, has frequently dogged her proposal. Eventually, Dhanraj brokered a compromise: trial the third-party provider on a handful of redundant pieces of equipment that could tolerate a longer downtime in the event of a catastrophe. Even then, fears of what could go wrong seem to consistently dominate the conversation instead of the possibility of achieving a comparable quality of service at a cheaper price. She said she’d rather the team focus on organizational goals rather than cave to these fears.

“There seems to be more of a deflecting to assumptions versus a collaboration,” Dhanraj said. “There are so many

unknowns here regarding OEM versus HTM partnerships that nobody wants to really speak about openly; health care leaders often remain with our assumptions about what would happen if we form these partnerships.”

“At the end of the day, we still need onsite folks,” she said. “Instead of being in competition or living in fear of the unknown, how about we have these internal conversations and find common ground that can work with both sides? [In-house] biomeds can be first responders for other pieces of equipment, and then have that partnership with other vendors so they can be collaborative overall.”

What can be done to overcome this reluctance to change tack? Dhanraj believes it will involve more and deeper director-level conversations to help decision-makers grasp how to balance quality of service with the price required to obtain it. She continues to push her colleagues to regard the work of HTM from a perspective of collaboration instead of fear.

“The next aspect is to have senior leadership really start driving this,” she said. “If we’re looking to be more cost-effective, what partnerships are out there? Start with the OEM, [saying], ‘We’re unable to meet your million-dollar contract if we’re looking at saving 30 percent as an organizational goal.’ Give the OEM the opportunity to course-correct with their pricing, lest we start looking at these other partnerships, from used equipment, to leased equipment, to independent service providers.”

“ISOs are getting smarter, training people on multiple pieces of equipment, or they have enough knowledge that they can be onsite and communicate with someone else, too,” Dhanraj said. “I think the third parties are really trying to be creative to bring this level of service, not only to compete with the OEMs, but to bring that competitive edge to fair market versus OEMs holding onto their market share.”

Eventually, the same pandemic financial crunch – namely, cost-cutting amid months of lost or reduced revenue opportunities across a variety of lines of service – that drives leaders like Dhanraj to broker lower-cost and creative rela-

ADVANCING THE IMAGING PROFESSIONAL

“ I think sometimes department heads unintentionally forget that they need to involve these other departments to pursue their desired initiatives, and to ensure everyone shares similar priorities that ultimately support the organizational vision.” –Nicole Dhanraj

tionships in HTM service delivery may drive the additional changes that she believes the industry needs. Although institutional needs vary from location to location, private-practice imaging centers “don’t seem to be as afraid to take that [ISO] risk,” she said, whereas larger corporate entities fear a loss of control over managing and maintaining even a handful of devices.

“I feel like right now there is a huge stop sign for any HTM group outside of the organization, so it’s difficult for them to penetrate and start having these conversations,” Dhanraj said.

“From the institutional side of it, we need to let our guard down, listen to it, be open, and have OEMs and HTMs collaborate and have the conversations about how can they meet our needs.

Also, the C-suite can engage with HTMs to understand their hesitations on pursuing these partnerships, and how working together with OEMs and HTMs especially can ensure their financial viability and continuity of services.”

William McGinnis, national sales director for medical technology software vendor ContextVision, of Stockholm, Sweden, has the benefit of experience in the medical device industry and the perspective of working with an OEM that partners with medical imaging customers and other OEMs. “We work with the largest of the large, to the strategic companies that we think we might have a good partnership with,” McGinnis said. “We have access to the experience of deploying so many different places inside your X-ray or ultrasound architecture, working with so much different technology, that [our clients] have an advantage that [they] can give to [their] partners. It gives us the opportunity for our partners to go and put their resources on working on what are true differentiators in the imaging market.”

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What McGinnis has found to be true of generating the kind of organizational change that leads to cost savings, improved quality of service, or simply finding a partner that’s the best match for the needs of an organization, is that doing any of these things requires buy-in from institutional leaders. However, it also requires support from people in positions throughout the organization; those who may not have the same input on high-level decisions nonetheless can contribute to the overall success of a good partnership.

“Maximizing the cost on every system is harder and harder,” McGinnis said. “It’s important that we spread our message to folks not just in the imaging department but other decision-makers throughout the organization.”

“You need to get wide and deep,” he said. “You need to be able to have the discussion with a CEO as easily as you do someone in IT or an algorithm developer. We start the engagement with representation from our entire team.

We’ll put together a group for each of our partners, from IT, from the algorithm team, from the business side, so what we can do from the very start is start to approach those pain points, and attack them very quickly.”

Being a good partner also means finding ways to calculate the return on investment (ROI) of any project on the table, which will be different in every circumstance depending upon customers, their needs and the environment in which they’re operating. Managing relationships with in-house teams makes ROI easier to calculate because the customers have some understanding of their current costs, McGinnis said. But projects that are “more abstract,” i.e., those in which the customers don’t have easy access to their internal metrics, are dealing in commoditized technologies, or don’t necessarily have needs that

match with what’s on offer, it’s also important to know when to table the conversation until both sides can get what they require out of the arrangement.

“It’s very important to establish what those cost barriers are early on and find out if this is something we want to do,” he said. “I don’t want to waste a red cent on a product that doesn’t have the potential to grow for us.”

Although McGinnis believes that the flexibility he can bring to the table in terms of fee structures and process improvements will benefit his clients in any circumstance, he also knows that none of those gains may be realized without clarity among partners on all sides of a deal.

“Most of our discussions begin in a consultative way,” he said. “Either we reach out to a customer, or they engage us, or we have an annual meeting like RSNA, and that’s where we’ll discover, ‘Can we help you out?’ The benefit to us from working with other partners expands our reach.”

Beyond those opportunities to yoke several disparate entities within a single proposition is an institutional culture that values collaboration, listens well to what its clients want and strives to improve on what’s already happening. Those are all hallmarks of effective partnerships, McGinnis said, and ones that any organization can learn to embrace.

“If you can establish that culture where people feel secure, and feel that they are a contributor, you’ll see that they may have a suggestion on how something can work that hasn’t necessarily been tried before, or how to use a different product to try something new,” he said. “You have to have that curious company culture that has to exist everywhere, even in a remote office; there has to be ways to connect to drive thoughts.” •

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INSIGHTS

EXTENDERS AND SUPERVISION

F CODING/BILLING

By Melody W. Mulaik, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA

our types of nonphysician professionals may be found in an imaging facility, assisting in or performing radiology services: physician assistants (PA), nurse practitioners (NP), registered radiologist assistants (RRA) and radiology practitioner assistants (RPA). The educational and training requirements are different for each of these professionals and therefore their corresponding scope of practice also varies.

PAs and NPs are frequently referred to as “nonphysician practitioners” and “mid-level providers.” RRAs and RPAs are frequently designated as physician “extenders.” For simplicity’s sake, in this discussion “extenders” will refer to all four designations while “nonphysician practitioners” will be limited to PAs and NPs. PAs and NPs are health care professionals licensed to practice medicine with physician supervision within state-established limits. Although there are some state-specific variations, these professionals generally can perform physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care and write prescriptions. Services performed by PAs and NPs can be billed to Medicare under their own name and number; however, not all payers will credential these providers.

RRAs and RPAs are registered radiological technologists (RRTs) who have taken additional educational coursework and training.

RPAs are sometimes incorrectly confused with PAs since both have the “PA” in their acronym. RRAs and RPAs are required to be supervised by a radiologist at all times. They are not trained, licensed and/or credentialed to interpret radiology studies. These designations are also heavily governed by individual state requirements that may limit their scope of practice.

Nonphysician practitioners may be able to perform and bill for services independent

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of a physician, depending on the Centers for Medicare and Medicaid Services (CMS) guidelines and state scope of practice statutes.

The supervision requirements are found in the Medicare Benefit Policy Manual, Chapter 15, Section 80 and for diagnostic radiology services there are three levels: general, direct and personal. All interventional procedures are designated as “concept does not apply” since the services should be performed and billed by the rendering provider.

The supervision guidelines in the Medicare Benefit Policy Manual apply to all sites of service and are not limited to physician offices and IDTFs. The required level of supervision for a diagnostic test is that which is indicated in the Medicare Physician Fee Schedule (MPFS).

Beginning in 2019, CMS allows RRAs and RPAs the ability to perform diagnostic tests under direct supervision if permissible by state law and state scope of practice regulations.1 The majority of states have statutes or regulations that recognize RRAs/RPAs and the supervision guidelines in these states for directly performed services are general or direct supervision. CMS did note that they did not changing the level of physician supervision required for exams, nor create a new supervision indicator, but rather just changed the guidelines.

In response to COVID-19 and as part of the Public Health Emergency (PHE), CMS expanded telehealth services to be more broadly accepted and applicable than the system was prior to the pandemic. CMS, for the duration of the PHE, has redefined direct supervision under MPFS to be provided through interactive real-time audio-video telecommunication technology. This may have a significant impact on radiology services where direct supervision can be performed via real time technology. This allows the physician to provide real-time assistance and direction throughout a procedure or service by allowing them to see and interact with the staff member and patient without adding ADVANCING THE IMAGING PROFESSIONAL

any unnecessary exposure. It is important to note, the supervision adjustments are meant as a minimum requirement. There may be circumstances in which the physical presence of the physician with the patient in the same location is necessary and more appropriate, for example administration of certain drugs or therapies.

CMS has finalized to extend direct supervision expansion under MPFS to end later in the calendar year in which the PHE ends or December 31, 2021. This will allow, along with other waivers and extensions, an easement to the change in supervision than immediate pending the end of the PHE and for physicians and practices to prepare for the change back to the in-person requirement The MPFS final rule makes permanent several workforce flexibilities provided during the COVID-19 PHE that allow non-physician practitioners to provide the care they were trained and licensed to give, without imposing additional restrictions by the Medicare program. Specifically, CMS finalized that non-physician practitioners such as nurse practitioners and physician assistants can supervise the performance of diagnostic tests within their scope of practice and state law, as long as they maintain required statutory relationships with supervising or collaborating physicians. CMS also finalized that diagnostic tests performed by a PA in accordance with their scope of practice and state law do not require the specified level of supervision assigned to individual tests, because the relationship of PAs with physicians would continue to apply. • https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/ clm104c23.pdf Melody Mulaik, CRA, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle Coding Strategies.

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INSIGHTS

PSYCHOLOGICAL SAFETY IN THE INTERVIEW PROCESS

T RAD HR

By Kiahnna Patton

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ime to interview! Whose palms are sweaty? Likely the candidate’s, and maybe yours too as the hiring manager. I remember when I first started interviewing candidates. I was probably just as nervous as they were and barraging myself with a ton of questions.

Questions like: • Am I asking the right questions?

• Am I making the candidate feel comfortable?

• Do I appear comfortable?

Nervous feelings elicited by those questions and a healthy dose of self-doubt were especially heightened when the interview

was for a critical role. Thankfully, I learned early not to strictly look for the unicorn candidate, but that knowledge didn’t take away the anxiety around making a wrong hire. What an employee relations nightmare and expensive misstep that could be!

Interviewers respond to their anxiety in different ways. Today, I want to reach those hiring managers who can’t resist intentionally making candidates sweat it out. This article speaks to those who fall into the “grill ’em” category and may not always get the talent they’re looking for because of their adversarial approach, even when it’s unintentional.

We’re going to take a closer look at how psychological safety can be applied to the interview process. And I’m going to make a very broad-sweeping comment and suggest that recruiters are generally skilled at this, so this article is for hiring managers who may not interview candidates as often or who need a little help.

I adore the topic of psychological safety. It applies so far beyond the workplace. So, what is psychological safety, and what’s the case for it in the interview process or otherwise? Psychological safety is the belief that you won’t face negative consequences for speaking up, making mistakes, or taking risks. Here’s a graphic I like that shows what a psychologically safe workplace might look like.

I’ve never understood why some interADVANCING THE IMAGING PROFESSIONAL

viewers aim to trip people up during the interview process.

What’s the goal? Where’s the benefit? I say, stop the nonsense! Create a psychologically safe process that allows interviewees to be transparent, to think more clearly, to have less anxiety exacerbated by meeting with you, and one that allows for space for the two (or more) of you to decide whether or not it is a match.

You can ask questions to understand how a person deals with pressure, but if they’re not applying to be a firefighter or little league coach, why the stress test? Stop playing interview dodgeball with people. Play catch instead.

Here’s how you apply it to the interview process: • Be clear about what the role is and is not. It’s not uncommon for new hires to say they felt deceived because the job posting differed from the actual work they were responsible for, and for others, the questions during the interview did not align with the job description.

• Share what makes the work environment psychologically safe.

• Share what the candidate can expect of teammates and leaders if they make a mistake.

• Be transparent. If it’s yet to be safe, what are you doing to remedy that? Where are you on that journey?

• Give honest feedback and don’t be afraid to do so during the interview. Of course, do this without creating unreasonable organizational risk or violating the law.

• Share ahead of time the specific topics you’d like to cover during the interview.

• Pay attention and be curious.

I will go a little rogue here and suggest that candidates be allowed a do-over. What if you had the chance to go back and address questions or topics you thought you could have answered better or more fully to give a more accurate picture of your qualifications? What if you realized you made a mistake with something you said but could use your one do-over to correct it. And this is beyond the usually one-sided thank you note. It is a conversation. I love the idea of giving a one-interview do-over. I’ve never heard of this being done, but I think it would be a wonderful way to demonstrate psychological safety.

Think about what might result if you demonstrate psychological safety from the beginning of the employment relationship through the end. What might you be able to create in the work culture? “Studies on psychological safety point to wide-ranging benefits, including increased confidence, creativity, trust, and productivity,” according to CNBC post (tinyurl.com/47v95det). Hopefully, in the age of the great resignation and the oh-so-popular trend of new hire and candidate ghosting, more companies are doing away with the nonsense. Hire right, hire safely, hire on! • Kiahnna D. Patton is senior human resources business partner at Children’s Hospital Los Angeles (CHLA) and a nonprofit founder.

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INSIGHTS

REMEMBER THE WHY A DIRECTOR’S CUT

By Lydia Kleinschnitz

fter a busy, chaotic day in the imaging department, have you ever stopped and wondered how you made it through?

Was your next thought then, “How can I do this again tomorrow?”

That is exactly what happened to me. An eventful workday started after an unsatisfying sleep. After dressing, I went downstairs for that all important first cup of coffee of the day. I poured the coffee into my cup and collected my bags. I took my bags, placed them into the car and started out. After several blocks I realized that I left the full coffee cup right on the counter where I had poured it. At that point I knew the day would be a challenging one.

When I arrived at work, the pages and the email started to pile up. The messages consisted of issues that all directors are probably familiar with: call offs, missing supplies, outpatient scheduling problems and on and on. During the past several months, staffing turnover and increased COVID-19 inpatient volume have been our major focus. On this

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day, probably because of my lack of coffee, every issue seemed magnified.

Working with our very talented leadership team we worked through the day’s staffing shortages by shifting dual registered techs to modalities where they were greatly needed. Some supervisors also worked the front line. Most importantly, we had to keep the communication open with our outpatients about the schedule and any possible delays.

As a director, I would much rather spend my day strategizing, capital equipment planning or planning for future imaging initiatives. Sometimes, however, these difficult days pop up. Lately it seems they are popping up more often.

After a day like I described, I have found that remembering why I decided to make health care my career or simply put, “the why”, has helped me get up the next morning to face it all again. If I remember what inspired me to take this journey, the day’s burden doesn’t seem so heavy. For me, my “why” comes from my father and the fact that I really enjoy helping people and making a difference.

My dad was a Navy Corpsman assigned to a MASH unit during the Korean war.

He often spoke of the care soldiers ADVANCING THE IMAGING PROFESSIONAL

received there. Those stories inspired me to go into the field of nursing, ultimately ending up in imaging.

When I remember the care patients need and what we do as an imaging team to provide diagnostic information that is critical for treatments, it drives me through the day. It inspires me to work and continue to provide the resources that my imaging teams need to do their job. Likewise, I have found that reminding staff to think about their “why” helps them to press through hard times.

During staff meetings, I ask individuals to share their why story in hopes that it will help others on the team to reflect and recall.

I don’t believe the staffing challenges and overall hospital staff shortages we are experiencing in western Pennsylvania are unique. I know staffing shortages and patient volumes are of great concern to other imaging departments across the country. As we face these difficult times, now is the time to remember your “why” to help you press on. Remembering why you do what you do will help you to continue to support your team in providing that vital high-quality imaging care. • Lydia Kleinschnitz, MHA, BSN, RN, is the senior director of imaging services at UPMC Presbyterian Shadyside.

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INSIGHTS

THE JOURNEY TOWARD BECOMING AN ACR BREAST CENTER OF EXCELLENCE

BY LISA LEE Lead Mammography Technologist

LET’S RIDE!

T

he journey to becoming a Breast Center of Excellence can be stressful, but it can also be inspiring and rewarding. It all starts with the American College of Radiology (ACR) – a governing board that works with the FDA to ensure that radiologists, technologists and all breast imaging equipment meet the operation requirements.

As far as the journey is concerned, let’s get in the driver’s seat and get started.

To be considered a Breast Center of Excellence, you must have the following modalities accredited by the ACR; mammography, breast ultrasound with a core biopsy, stereotactic core biopsy and a breast MRI. The process starts – Lisa with an online application asking you to include all your site’s modality information, personnel credentials, productivity statistics, physicist reports and more. It’s a comprehensive application, so be sure to take the time to fill it out as completely as possible (focus and patience are key!) Once the application is approved and your fees have been received, a notification will be sent to you to begin collecting your images. You will be given 45 days to find

your breast center’s best images for submission, and the ACR provides image guidelines for you to follow. Images must be a Bi-Rad 1, and they require examples of both fatty and dense breasts. These requirements can be stressful; not all patients are the same shape and size, and meeting the guidelines can be challenging, but it’s certainly not insurmountable. You can do this! Keep driving.

If you’re looking to go through this journey, begin to gather what you need now.

Get your roadmap out.

Here at Banner Imaging, we have a technologist in each modality who keeps track of all the cases that meet the guidelines. As the due date for image submission approaches, I look through the mammograms and pick two to three of the best cases. I then meet with our lead interpreting physician, and together we will determine the best case to submit.

Lee Once we have selected our best images, I access the material package link. There are many questions about our infectious control program, how we notify patients and referring physicians of results and pathology outcome audit. There’s also detailed and required information required on the specific unit being accredited and information about the radiologist’s reading stations. Personnel documents are needed with qualifying dates, productivity statistics

“If you’re looking to go through this journey, begin to gather what you need now. Get your roadmap out.”

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and continuing education totals for all radiologists, technologists and physicists. Images are then uploaded on a secure system within the material link.

Once this is all completed, the link is then submitted for evaluation. For me, the second stressful part is sitting in traffic, so to speak, waiting to hear the results. This can take anywhere from two to four months. The ACR will send a link to the final report, and with fingers crossed, we hope to read, “You have been granted accreditation.” Each breast imaging unit goes through this process every three years.

Once accreditation has been granted in the four modalities listed at the beginning of this column, your center is a Breast Center of Excellence. You will then receive a certificate that you can proudly display. It is very rewarding to

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know that our center performs with the highest quality of images, personnel and equipment. Across Banner Imaging, I oversee 16 mammography centers, four of them are a Breast Center of Excellence.

Our newest breast center will become a Breast Center of Excellence in the first quarter of 2022, giving us a total of five. The keys to a successful QA program, I believe, is a good organization and a team of technologists and radiologists that all share a passion for providing the best quality of care.

Now, hit the accelerator and head toward excellence! • Lisa R Lee, ARRT (R) (M), is the mammography lead at Banner Imaging.

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INSIGHTS

FOGGED MEMORY “O

h, yes this is so beautiful,” the 86-year-old mother of seven said as she gazed upon the Grand Canyon in Arizona.

PACS/IT/AI

By Mark Watts

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I had just asked my mother if she was enjoying the view. This was a calm moment. Her eyes sparkled like they did after I had won a hurdle race or scored a winning touchdown.

Moments later, the fog of dementia rolled in and clouded our trip and she asked me, her son, “and who are you?”

This is the roller coaster of loving someone with Alzheimer’s disease.

When you have an intimate and personal concern about a familial disease, new research piques your interest.

Artificial intelligence in health care can be like a smartphone for telecommunications. A multi tooled platform with perfect memory, unlimited reach and tireless effort.

The ability to review a brain scan at the pixel level and compare each pixel to the surrounding ones to recognize patterns unappreciated by humans.

Researchers are training an artificial intelligence (AI) system that can potentially diagnose dementia after a single brain scan.

The team, led by Professor Zoe Kourtzi,

a Fellow at the Alan Turing Institute, and a professor of computational cognitive neuroscience at the University of Cambridge, has developed machine learning tools that can detect dementia in patients at a very early stage. Using brain scans from patients who went on to develop Alzheimer’s disease, their machine learning algorithm learned to spot structural changes in the brain. When combined with the results from standard memory tests, the algorithm was able to provide a prognostic score – that is, the likelihood of the individual having Alzheimer’s disease.

Currently, it can take several scans and tests to diagnose the disease. For those patients presenting with mild cognitive impairment – signs of memory loss or problems with language or visual/spatial perception – the algorithm was over 80% accurate in predicting those individuals who went on to develop Alzheimer’s disease. It was also able to predict how fast their cognition will decline over time.

Kourtzi said, “We have trained machine learning algorithms to spot early signs of dementia by looking for patterns of grey matter loss – essentially, wearing away – in the brain. When we combine this with standard memory tests, we can predict whether an individual will show slower or faster decline in their cognition.”

ADVANCING THE IMAGING PROFESSIONAL

She goes on to say, “We’ve even been able to identify some patients who were not yet showing any symptoms but went on to develop Alzheimer’s. In time, we hope to be able to identify patients as early as five to 10 years before they show symptoms as part of a health check.”

Although the algorithm has been optimized to look for signs of Alzheimer’s disease, Kourtzi and colleagues are now training it to recognize different forms of dementia, each of which has its own characteristic pattern of volume loss.

Dr. Timothy Rittman from the department of clinical neurosciences and a consultant at Addenbrooke’s Hospital, part of Cambridge University Hospitals (CUH) NHS Foundation Trust, is leading a trial to look at whether this approach is useful in a clinical setting.

To date around 80 patients have taken part in the trial, which was run by CUH, Cambridgeshire and Peterborough

NHS Foundation Trust and two NHS trusts in Brighton.

There are currently very few drugs available to help treat dementia. One of the reasons that clinical trials often fail is because it is thought that once a patient has developed symptoms, it may be too late to make a major difference.

Having the ability to identify individuals at a very early stage could therefore help researchers develop new medicines.

If the trial is successful, the algorithm could be rolled out to thousands more patients across the country If I was given a chance to know my mother’s slide into dementia was coming, I could have planned this trip years ago so that we could enjoy the view together. • Mark Watts is the enterprise imaging director at Foundation Hills Medical Center.

IMAGING SYSTEMS YOU AND YOUR PATIENTS DESERVE From adding another MRI unit to handle your patient backlog, to providing a short-term solution while upgrading your current unit, to adding a new service, KMG has the right imaging systems to keep you running efficiently and affordably.

612-757-6714 kingsmedical.com contact@kingsmedical.com

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INSIGHTS

HOW BAD MANNERS CAN BE GOOD FOR YOU EMOTIONAL INTELLIGENCE

By Daniel Bobinski

D

isplaying bad manners is never good for your reputation or your business, but when a vendor or client is rude, impolite, or discourteous, it can help you decide how – or if – you want to proceed with that relationship. After all, choosing to sever ties with a rude person might save you a lot of headaches.

As a case in point, not long ago I observed bad manners in a potential vendor, and it made me decide not to do business with that person. The situation was a business lunch. Even though the restaurant’s menu had a large variety from which to choose, nothing seemed to work for this person.

The person acted very disgruntled and begrudgingly asked for the chef to make something that was not on the menu.

When the dish arrived, the person became the ultimate prima donna, pushing the plate back toward the server as if it contained a flesh-eating, carcinogenic bile. That action was accompanied by a snide comment, “Can you take that back

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ICEMAGAZINE | NOVEMBER 2021

and have them fix that? That’s not what I ordered.” I cringed in embarrassment at the condescending and snobbish behavior of this person.

I had noted a few previous sideways statements from this person that had raised my eyebrows a few times, but I was hoping that those were anomalies. Maybe the person was just having a bad day or was experiencing a lot of stress at home.

Thankfully, the restaurant incident went over the line, and I realized what I needed to do.

An old maxim played loudly in my head: A person who is nice to you, but not nice to the server, is not a nice person.

I knew that if I entered a business relationship with this person, I would eventually receive the same treatment, so later that day I informed this individual I would be choosing a different vendor.

WHEN BAD MANNERS DETERIORATE YOUR WORKPLACE

The situation is different if you’re an employee and don’t have much control over your company’s vendors or who your comADVANCING THE IMAGING PROFESSIONAL

pany hires. Therefore, what follows are a few suggestions for when clients, vendors or coworkers are rude and you are required to deal with them: • Remain objective. Making sideways or insulting comments toward a rude person may bring you temporary enjoyment, but professionalism wins in the end. I recall a vendor pressing a point with me that I thought was unreasonable.

The conversation could have easily turned into an insult contest, but I held to the main points and kept it objective, not personal. I talked about the issues and didn’t make any negative comments about his perspective. Ten minutes later the issue was resolved to both of our satisfaction, after which the vendor told me, “You know, I really appreciate the way you handled that.”

• Get help if necessary. Whether your trouble is with a client, vendor or coworker, sometimes you’re better off talking with your manager about someone else’s bad manners. Your manager might offer a bit of sage advice, or maybe even step in to change the environment. I believe it’s better to iron out the wrinkles in a strained relationship than it is to separate two parties without even trying. That said, if total separation is the best solution, so be it.

• Exercise compassion. This can be difficult to do, especially if the rude person is making personal comments about you or attacking your integrity.

However, if people are rude for

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no apparent reason, it is possible such people are unhappy about something in their life, or something tragic has happened, and they’re just taking it out on you. It could also be a self-esteem issue, or perhaps a personal problem is weighing them down.

• The key is to remember when dealing with rude people is that it’s their problem, not yours. You are free to mentally reject any “stuff” they try to lay on you. A quote that’s often attributed to Eleanor Roosevelt (although there’s no proof she actually said it) is, “Nobody can make you feel inferior without your consent.” In other words, you would have to care about what someone says or thinks for it to bother you.

THE SOCIAL MEDIA PHENOMENON

For some reason, people feel freer to be sarcastic and insulting on social media platforms than they are in real life. If you’re on any of these platforms, you’ve probably seen it. One practice I recommend is not engaging in conversations where someone is obviously baiting an argument. Social media is not the place to iron out differences of opinion, so just keep scrolling when someone gets snippy.

The saying used to be that Facebook is a place best reserved for cat pictures. With that in mind, if someone starts getting rude or insulting with me, I will sometimes just post a picture of a cat and then stop participating in the conversation. But mostly I just keep scrolling.

STAY PROFESSIONAL

By doing your what you were hired to do to the best of your ability and truly assisting such people, even when they’re rude, know that you are pouring kindness all over them – and that’s a good thing. If you think about it, not only could you be the only person that treats such people with respect that day, it’s possible that the light you shine into their life might begin to melt their hardening heart.

Bottom line, no “one-size-fits-all” answer exists, but if you observe someone displaying bad manners, do be aware that they may eventually get turned on you. And if that happens, one choice might be to avoid doing business with that person altogether.

If that’s not possible or realistic, stay objective and get help if necessary. And, you might even choose to take pity on such people and cover them with compassion.

The idea is that when you are on the receiving end of bad manners, you can either let it put a stain on your day, or you can respond in a way that won’t sully your own reputation. • Daniel Bobinski, M.Ed. is a bestselling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him on his office phone, 208-3757606, or through his website, www.

MyWorkplaceExcellence.com.

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INSIGHTS

THE PLUMBER I

recently had a customer relations encounter with a plumber that I want to share with you.

The water here in Las Vegas apparently consists of approximately 10% sand and 20% bricks. A water softener is a must and we installed one within a week of moving here.

THE ROMAN REVIEW

BY MANNY ROMAN, CRES

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ICEMAGAZINE | NOVEMBER 2021

We recently decided that lugging around hundreds of pounds of bottled water was not good for the environment, my back and my wallet. We bought a digital water quality tester and it showed that the incoming water was way in the red. The bottled water was way in the green. We were convinced. We wanted to install a reverse osmosis system under the kitchen sink rather than a whole house system.

The toilets probably don’t care that the water would be soft and drinkable.

After researching the available options to death, and learning much more than I care to remember, I decided on a six-stage filtration system. Videos from YouTube, the manufacturer and others demonstrated that this system would be easily installed. Any normal individual should be able to implement an installation within 30 minutes including cleanup. I, however, do not fit the normal category, nor do I easily fit under the kitchen sink.

The solution was to call a plumber that I have used a few times in the past.

I have been happy with his work and his pricing. We agreed on a date and time for the installation. Then, things got interesting.

When he saw that there were six filters and a small integrated pump involved he became visibly disturbed which surprised me. He told me that I should not have bought such a complex system. That he sells a four-stage system that is sufficient.

He broke a few customer relationship skills laws here. He obviously had not attended any customer satisfaction skills training.

Rule #1: Know what you will be working on and, if necessary, research possible issues before you approach the customer and/or the equipment. He should have asked what I bought and if it was new to him research the installation process.

Rule #2: Always be prepared to answer 10 likely questions and have the actual speech ready so you do not break Rule #3.

Rule #3: Be prepared to NOT say 10 boneheaded things, like “You should not have bought this in the first place.” If you are going to tell a customer that they committed an error in a purchase, you better have a good speech prepared.

How you frame your statements should ensure that the customer does not feel stupid or chastised.

It became obvious that he did not wish to follow the very simple installation proADVANCING THE IMAGING PROFESSIONAL

cedure. The pictures of the completed project really are enough to finish the job. Everything is color coded. However, I had to point out which picture to follow as he continued complaining that this system was all wrong.

Rule #4: If you need extra time to calm down and explore the project for simplification, remove the customer from the area. “I will need to look at this more closely. Please give me about 20 minutes and I will get back to you. Where will you be?” This question is actually a request that the customer go away but presented in a nicer way.

I realized that my presence was detrimental, so I turned the air conditioner to cold and fans on to help since he was by now sweating profusely then went to another room.

About 20 minutes later he cried out that everything was leaking and he needed a bucket and some towels.

Rule # 5: Anticipate the time, talent and tools needed for the job and have them readily available.

After much manipulation, sweating and under-the-breath cursing all was well except the last stage of the system. It continued to leak. I suggested that, since it was the last stage and it

ICE WWW.THEICECOMMUNITY.COM

just added some minerals back to the filtered water, we should bypass it for now. His relief at this was palpable.

This project should have been about 30 minutes. It took just over 2 hours. I could have been upset but he implemented Rule #6: Do not charge for your incompetence and lack of preparation. He did not even attempt to charge more than the agreed-to fee.

Regarding the bypassed filtration: It is good to have a neighbor who fits under sinks and will work for a glass of wine. •

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ICEMAGAZINE

49

Imaging Jobs

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ompanies like ours have such a difficult C time finding qualified candidates for field service roles that it just made sense to publish our opening with HTMJobs.

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HTM Imaging Technician III

Diagnostic Imaging Equipment Services Engineer II

Field Service Engineer

We provide a robust orientation program to set you up for success. Opportunities for employee development include project and time management, temperament training, leadership academy topics, and vendor-provided technical training. Some travel may be required depending on the facilities you support. Future career growth includes opportunities in medical imaging, planning, security, integration and quality areas. In addition, tuition reimbursement and tuition discounts are available for continuing education costs.

Universal Medical Resources, a leader in Nuclear Medicine Sales, Service, and Parts has openings for experienced Field Service Engineers throughout the United States. Field Service Engineers are assigned a territory where they are responsible for maintaining nuclear medicine equipment at customer’s sites. The position requires frequent travel within the territory as well as occasional travel outside the assigned territory.

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

Field Service Engineer-CT/MR

Video Monitoring Tech

Clinical Engineering Imaging Technician I

Ensures that medical imaging equipment is repaired in a timely manner, works reliably, is safe to operate and functions properly. Consistently demonstrates a mastery of the skills necessary to perform preventive maintenance, quality assurance testing, equipment calibrations, installations, and corrective maintenance on a variety of imaging equipment.

Provides intermediate support services to a varying range of medical and imaging equipment and related systems for departments throughout The MetroHealth System with a focus on technical, complex, and sophisticated equipment. Troubleshoots, repairs, calibrates, and verifies the performance of medical imaging equipment including, but not limited to, general radiographic rooms, portables, mammography, ultrasound, and supporting equipment. Interacts with department staff and management in assigned departments as needed to identify and reduce operator errors, equipment failures, down time, and costs.

The Field Service Engineer is responsible for maintaining the customer’s high-end medical imaging equipment, including systems applications, quality control, calibration, operating system support, applications support, software support, technical support, and troubleshooting

Provides continuous observation and surveillance of assigned patients. Verbally redirects patients from engaging in at risk behaviors. Summons the nursing staff if the patient requires assistance.

Is knowledgeable and supportive of patient and institutional confidentiality.

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

Ultrasound Tech-Reg

Imaging Field Service Engineer II (X-Ray)

Diagnostic Imaging Equipment Technician

The Field Service Engineer is responsible for maintaining the customer’s high-end medical imaging equipment, including systems applications, quality control, calibration, operating system support, applications support, software support, technical support, and troubleshooting. This position will be part of an onsite team and cover general imaging.

We provide a robust orientation program to set you up for success. Opportunities for employee development include project and time management, temperament training, leadership academy topics, and vendor-provided technical training. Some travel may be required depending on the facilities you support. Future career growth includes opportunities in medical imaging, planning, security, integration and quality areas. In addition, tuition reimbursement and tuition discounts are available for continuing education costs.

Performs high-quality Ultrasound procedures within the scope of state licensure at a technical and professional level that does not require direct supervision. Performs appropriate patient evaluation and uses proper technical factors for diagnostic image production.

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

VIEW FULL DETAILS www.htmjobs.com

VIEW JOB DETAILS AT HTMJOBS.COM

AMSP

SPONSORED CONTENT

AMSP MEMBER DIRECTORY I M A G I N G Brandywine Imaging, Inc. www.brandywineimaging.com 800-541-0632

Interstate Imaging www.interstateimaging.com 800-421-2402

King's Medical Group www.kingsmedical.com 612-757-6714

Medlink Imaging www.medlinkimaging.com 800-456-7800

Preferred Diagnostic Equipment Service, Inc. www.pdiagnostic.net 951-340-0760

Radon Medical Imaging www.radonmedicalimaging.com 800-722-1991

The Association of Medical Service Providers (AMSP) is the premier national association of independent service and products providers to the health care technology industry.

Our large pool of modality specialists provide for lower costs and higher quality services for our customers throughout the U.S. Learn more at www.amsp.net.

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ICEMAGAZINE | NOVEMBER 2021

ADVANCING THE IMAGING PROFESSIONAL

SPONSORED CONTENT

MEMBER PROFILE

KINGS MEDICAL GROUP

B

ased in Richfield, Ohio, Kings Medical Group (KMG) is an employee-owned company that provides full service turn-key imaging solutions. Every facility has different needs, budgets, timelines and patient bases.

“We will work with you to determine what imaging solutions are best for you and your operations,” said KMG National Sales Executive Zach Johnson. “With KMG’s vast experience in both interim and fixed-base imaging solutions and our long-standing partnerships with every leading manufacturer of MRI, CT and PET/CT equipment, your facility will have a clear vision of what success looks like.”

ICE learned more about KMG in a recent interview with Johnson.

Q: WHAT COVID-19 CHALLENGES HAVE YOU FACED AND HOW DID YOU OVERCOME THEM? A: A major COVID-19 challenge has

been dealing with budget cuts and upgrade delays. Throughout the pandemic, our team has focused on providing help to hospitals/imaging centers with our mobile units. KMG imaging systems have been used to separate potential COVID-19 potential patients and more.

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Q: HOW DOES KMG STAND OUT AMONGST ITS COMPETITORS? A: We focus on providing each facility

with systems that will benefit their needs. As a small company, we understand that service and relationships are just as important as providing high-end imaging units. It starts with our CEO, Kim Jacobs, who is always looking out for each of our customer’s best interests.

Q: DO YOU HAVE ANY NEW PRODUCTS OR SERVICES YOU CAN TELL US ABOUT? A: KMG is looking for hospitals and imaging systems to partner with on suite renovations and new systems.

Our team is ready to help you handle everything from planning, project management, selecting a new system and more.

Q: WHAT IS ON THE HORIZON FOR KMG? A: KMG is adding multiple new mobile MRIs to our fleet this year along with some awesome new fixed imaging projects. Readers can stay up-to-date on our social media pages.

ZACH JOHNSON KMG NATIONAL SALES EXECUTIVE

Q: WHAT ELSE WOULD YOU LIKE OUR READERS TO KNOW? A: Over the past four decades, KMG

has served over 200 clients by providing state-of-the-art interim and fixedbase imaging solutions to facilities nationwide. However, unlike most other imaging solution providers, we have a first-hand understanding of what it means to provide care to patients because we owned and operated nearly 20 independent imaging centers across the country. This gives us a unique perspective of what is needed to best serve communities, hospitals, imaging centers and physician offices in rural, suburban and urban regions.

Our experience of serving both the medical and patient communities has helped us evolve into what we are today. Completely employee-owned, every KMG team member has the authority and obligation to do whatever it takes to create a positive outcome for your facility. The latest equipment to unmatched services, interim options to full fixed-base suites, KMG will work with you to create a custom-tailored solution that works best for you, your facility and your patients.

For more information, visit www.kingsmedical.com.

ICEMAGAZINE

53

INDEX

ADVERTISER INDEX Association of Medical Service Providers (AMSP) p. 52

International X-Ray Brokers p. 37

Avante Health Solutions p. 2

KEI Medical Imaging p. 27

MW Imaging Corp. p. 5

PM Imaging Management p. 41 Beekley Medical p. 17

King's Medical Group p. 45, 53

TECHNICAL

PROSPECTS

Experts in Siemens Medical Imaging

Technical Prospects p. 21

Diagnostic Solutions p. 37 Medical Imaging Solutions p. 23

Health Tech Talent Management p. 39

MedWrench p. 28

TransAmerican Medical p. 17

SOLUTIONS

TriImaging Solutions p. BC HTMjobs.com p. 50-51 Metropolis International p. 43 UMAC p. 3

ICE Webinars p. 12

Injector Support and Service p. 4

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ICEMAGAZINE | NOVEMBER 2021

MIT Labs p. 41

W7 Global, LLC. p. 49

ADVANCING THE IMAGING PROFESSIONAL

“If you are prepared, you will be confident, and will do the job.” - Tom Landry

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